Topics Related to Physicians, Physician Assistants and Nurse Practitioners

Effective with date of service Oct. 16, 2018, the NC Medicaid and Health Choice programs cover immune globulin intravenous, human - ifas (Panzyga®) for use in the Physician Administered Drug Program when billed with HCPCS code J1599 - Injection, Immune Globulin, Intravenous, Non-lyophilized (e.g. liquid), Not Otherwise Specified, 500 mg.

Effective with date of service Oct 3, 2018, the NC Medicaid and Health Choice programs cover filgrastim-aafi injection, for subcutaneous or intravenous use (Nivestym) for use in the Physician Administered Drug Program when billed with HCPCS code Q5110 - Injection, Filgrastim-aafi, Biosimilar, (Nivestym), 1 microgram. Nivestym is available in a single-dose prefilled syringe containing either 300 mcg/0.5 mL or 480 mcg/0.8 mL.

Effective with date of service Oct. 22, 2018, the NC Medicaid and Health Choice programs cover moxetumomab pasudotox-tdfk for injection, for intravenous use (Lumoxiti™) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not Otherwise Classified, antineoplastic drugs.

Effective with date of service Nov. 2, 2018, the NC Medicaid and Health Choice programs cover crotalidae immune f(ab’)2 (equine), lyophilized powder for solution for injection for intravenous use (Anavip®) for use in the Physician Administered Drug Program when billed with HCPCS code J3590 - Unclassified biologics.

Effective with date of service Oct. 8, 2018, North Carolina Medicaid and NC Health Choice programs cover cemiplimab-rwlc injection, for intravenous use (Libtayo) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not Otherwise Classified, Antineoplastic Drugs.

Effective with date of service Oct. 3, 2018, North Carolina Medicaid and NC Health Choice programs cover mogamulizumab-kpkc injection, for intravenous use (Poteligeo), for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not Otherwise Classified, Antineoplastic Drugs.

Effective with date of service May 1, 2018, the Medicaid and NC Health Choice (NCHC) programs cover burosumab-twza injection, for subcutaneous use (Crysvita) for use in the Physician's Drug Program when billed with HCPCS code J3590 - Unclassified biologics. Crysvita is available as a subcutaneous injection as 10 mg/mL, 20 mg/mL or 30 mg/mL in a single-dose vial.